MEDICARE: HARRISON MEMORIAL HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	252Y00000X	Early Intervention Provider Agency
2	282N00000X	General Acute Care Hospital	KY
3	282N00000X	General Acute Care Hospital

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000054476	OTHER	KY	ANTHEM LEGACY PROV. #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629084702
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARRISON MEMORIAL HOSPITAL

Provider Business Mailing Address
First Line	:	1210 KY HIGHWAY 36 E
Second Line	:
City	:	CYNTHIANA
State	:	KY
Zip	:	41031-7498
Country	:	US
Telephone Number	:	859-234-2300
Fax Number	:	859-235-3699

Provider Business Practice Location Address
First Line	:	1210 KY HIGHWAY 36 E
Second Line	:
City	:	CYNTHIANA
State	:	KY
Zip	:	41031-7498
Country	:	US
Telephone Number	:	859-234-2300
Fax Number	:	859-235-3699

Authorized Official
Title or Position	:	CEO
Name	:	DR. STEPHEN K. TOADVINE
Credential	:
Telephone Number	:	859-235-3503

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	02/02/2023

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Directions to “HARRISON MEMORIAL HOSPITAL ” Practice Location

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